Ocular syphilis

Introduction and objective: To describe the ocular and general characteristics and to assess prognosis of patients with uveitis, whose syphilis infection was revealed during uveitis workup. Method: Between 2011 and 2019, 14 uveitis patients were diagnosed with syphilis (13 males, 1 female) with symptoms in 25 eyes. Patients' clinical records were analyzed retrospectively. Results: The mean age of patients was 46 years (range 23-72 years). 2 patients did not show up for further dermatological and ophthalmic examinations, and 1 patient was treated at another institute. In the 11 patients we treated, the mean visual acuity observed for the first time in the eyes affected by inflammation was 0.71 (0.001-1.0) in the right eye and 0.53 (0.04-1.0) in the left eye. The mean follow-up was 22 months (1-72). At the end of the follow-up period, the mean visual acuity was 0.9 (0.15-1.0) in the right eye and 0.82 (0.08-1.0) in the left eye. The most common ocular manifestation was posterior uveitis (papillitis, chorioretinitis, or in combined forms) in a total of 20 eyes. After receiving penicillin therapy according the neurosyphilis protocol, inflammatory symptoms resolved in all patients, and at the end of the follow-up, the majority of patients had complete visual recovery. Lower visual acuity was due to optic nerve atrophy and macular damage. Conclusion: In our case series, the patients were predominantly middle-aged men. Although most patients showed posterior segment involvement, with appropriate treatment the visual outcome was good.